Causes of blindness and the results of cataract surgical intervention in the Micronesian islands: a retrospective study

Abstract

Since 1983, we have delivered eye care to inhabitants of the Micronesia islands a total of 18 times over an 18-year period. Approximately 14,000 islanders were examined. We diagnosed a total of 1226 blind eyes and 1231 eyes with low vision. Unoperated cataract (n = 765, 62.4%) was the leading cause of blindness in our data, and 611 cataract operations were performed. The preoperative visual acuity of the patients who underwent cataract surgery was less than 20/200. Visual acuity improved in 588 cases (96.2%) after the surgery. Sight-threatening complications occurred in 1.1% (7) of the eyes after the surgery, which is comparable to the rate in developed countries. Corneal opacity secondary to infection (11.2%) was the second leading cause of blindness in our data. Diabetic retinopathy (9.9%) was a cause of low vision in our data, and the number of eyes diagnosed with diabetic retinopathy in each district increased over the years. Glaucoma was the cause of blindness in 1.9% of the blind eyes, although the percentage may actually have been higher because visual loss was assessed only by reduced visual acuity. The demand for correcting refractive errors that caused a visual acuity of less than 20/60, was evident throughout the region. The majority of blind individuals in this study were suffering from operable cataract and good results were obtained with cataract surgery in this region. Further training of local medical staff would significantly improve eye care services in Micronesia.